HIV and COVID-19

Clinical description

• PLHIV are at increased risk of severe COVID-19, especially those with advanced HIV disease

and older people and with NCDs and co-morbidities.

• PLHIV with COVID-19 often have other severe OIs that need diagnosis and treatment.
• Patients may avoid coming to health facilities during COVID-19 waves, leading to ART

interruption.

• COVID-19 vaccination is safe and effective in PLHIV, those with low CD4 may have a weaker

and more short-lived immune response.

• COVID-19 vaccine is safe in pregnancy and during breastfeeding period, there is an added

advantage of antibody transfer to infants.

• HIV infection and ART do not change standard COVID-19 treatment protocols. There are no

relevant drug interactions of standard ARVs with locally available and evidence-based treatments for COVID-19 (enoxaparin and dexamethasone).

• There is no evidence that any ARV used for treating HIV is effective for prevention and

treatment of COVID-19.

COVID-19 prevention

• Recommend full COVID-19 vaccination to all eligible PLHIV, including pregnant and breastfeeding

women.

• Emphasize importance of adhering to standard COVID-19 prevention measures e.g., proper

wearing of face mask, hand washing, social distancing and avoiding overcrowded/closed spaces.

HIV and COVID-19 investigations

• Offer a COVID-19 test to all PLHIV with symptoms and/or signs of COVID-19.
• Ascertain current HIV status for all patients admitted for COVID-19 treatment.
• Investigate all PLHIV with COVID-19 for TB: Xpert MTB RIF, microscopy and urine TB LAM.
• Investigate all PLHIV with COVID-19 for OIs such as PJP and TB.
• Conduct a targeted HIV viral load for all COVID-19 in-patients without a viral load result in the last

3 months.

Preventing HIV service disruptions

• Inform all PLHIV accessing care about continued availability of HIV services during COVID-19 waves.
• Enrol all stable PLHIV into multi-months dispensation to decongest facilities and ensure

uninterrupted availability of ARVs with patients.

• Do not prescribe ARVs for COVID-19 prevention and treatment.